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目的:系统性评价持续气道正压通气(CPAP)对阻塞性睡眠呼吸暂停低通气综合征(OSA)合并难治性高血压患者血压的影响。方法:计算机检索Cochrane Library、PubMed、ScienceDirect、Web of Science等数据库并手工检索相关期刊,查找CPAP治疗对OSA合并难治性高血压患者血压影响的临床随机对照试验(RCT),对符合条件的RCT,逐一评价质量,提取资料,采用RevMan5.3和R 3.2.2软件进行Meta分析。结果:共纳入7篇RCT研究。Meta分析结果显示:CPAP治疗后,患者24h平均收缩压/舒张压较对照组有显著改善(P<0.05)。24h平均收缩压/舒张压合并效应统计结果为:[WMD=-5.36,95%CI:(-8.60,-2.11),P=0.001;I~2=70%]/[WMD=-4.21,95%CI:(-6.39,-2.04),P=0.000 01;I~2=79%]。结论:CPAP治疗可有效地降低OSA合并难治性高血压患者的血压。
Objective: To systematically evaluate the effect of continuous positive airway pressure (CPAP) on blood pressure in obstructive sleep apnea-hypopnea syndrome (OSA) patients with refractory hypertension. Methods: A computer-aided search of databases such as Cochrane Library, PubMed, ScienceDirect and Web of Science and manual search of relevant journals to find a randomized controlled trial (RCT) of CPAP on blood pressure in OSA patients with refractory hypertension. , One by one to evaluate the quality, extract data, the use of RevMan5.3 and R 3.2.2 software for meta-analysis. Results: Seven RCTs were included. Meta analysis showed that after CPAP treatment, the average 24h systolic blood pressure / diastolic blood pressure was significantly improved (P <0.05). The mean systolic / diastolic blood pressure combined effect at 24 h was [WMD = -5.36, 95% CI: (-8.60, -2.11), P = 0.001; I ~ 2 = 70%] / [WMD = -4.21,95 % CI: (-6.39, -2.04), P = 0.000 01; I ~ 2 = 79%]. Conclusion: CPAP can effectively reduce the blood pressure in OSA patients with refractory hypertension.